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Utah Medicaid Autism Waiver

What's New

In July 2014, the Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees state Medicaid programs, provided an informational bulletin to Medicaid agencies throughout the nation. The bulletin informed state Medicaid agencies that they must begin providing autism spectrum disorder (ASD)-related services to children under 21 through the general Medicaid benefit. This is a significant change from previous CMS guidance. (A copy of the July 2014 CMS Informational Bulletin, Clarification of Medicaid Coverage of Services to Children with Autism is attached).

Through a home and community based waiver program, Utah Medicaid currently offers ASD-related services to a limited population (children ages 2 through 6). Under the recent CMS guidance, Medicaid will be required to serve any Medicaid eligible client under 21.

Over the past few months, the Medicaid agency has been developing draft ASD services policy. Throughout the initial development, Utah Medicaid sought the advice and guidance of experts from Primary Children’s Medical Center, the University of Utah and Utah State University.